RICARDO FERREIRA BENTO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina - Docente
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina - Líder
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/32 - Laboratório de Otorrinolaringologia, Hospital das Clínicas, Faculdade de Medicina - Líder
12 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 12
- Prof. Dr. Aroldo Miniti - A Great Master(2016) BENTO, Ricardo Ferreira
- Minimally Invasive Surgery for Intracochlear Schwannoma Removal and Simultaneous Cochlear Implantation(2016) BENTO, Ricardo Ferreira; GEBRIM, Eloisa Maria Mello Santiago; MAGALHÃES, Ana Tereza de Matos; PEREIRA, Larissa Vilela; FONSECA, Anna Carolina de OliveiraAbstract Introduction Hearing preservation has not yet been reported in patients undergoing resection of intracochlear schwannomas. This study describes a minimally invasive procedure for intracochlear schwannoma resection with simultaneous cochlear implantation that resulted in good hearing. Objective This study aims to describe a minimally invasive procedure for intracochlear schwannoma resection with simultaneous cochlear implantation. Data Synthesis The technique described in this study was developed for a 55-year-old male with a 20-year history of bilateral progressive hearing loss and tinnitus that had a mass in the left apical turn of the cochleameasuring 0.3 cm. Surgery accessed the apical turn of the cochlea. We performed mastoidectomy and posterior tympanotomy and removed incus and tensor tympani muscle to expose the cochlear apex. The tumor was identified and completely resected. After the cochleawas anatomically preserved, it was implanted with a straight electrode via round window insertion. The histopathological examination confirmed intracochlear schwannoma. Speech perception test revealed 100% speech recognition with closed sentences and the average audiometric threshold (500 to 2000 Hz) was 23 dB. Conclusion Our technique led to rehabilitation of the patient and improved hearing without damaging the intracochlear structure, making it possible to perform CI in the same procedure with good results.
- Evaluation of Functional Outcomes after Stapes Surgery in Patients with Clinical Otosclerosis in a Teaching Institution(2016) SOUZA, José Celso Rodriques de; BENTO, Ricardo Ferreira; PEREIRA, Larissa Vilela; IKARI, Liliane; SOUZA, Stephanie Rugeri; TORRE, Ana Adelina Giantomasi Della; FONSECA, Anna Carolina de OliveiraIntroduction Otosclerosis is a primary disease of the temporal bone that leads to stapes ankylosis. Hearing loss is the main symptom. Treatment includes surgery, medical treatment, and sound amplification therapy alone or in combination. Objective To evaluate the functional outcomes of patients with clinical diagnosis of otosclerosis undergoing primary stapes surgery in a teaching institution. Method Retrospective descriptive study. Results A total of 210 ears of 163 patients underwent stapes surgery. Of the 163 patients, 116 (71.2%) underwent unilateral surgery and 47 (28.8%) underwent bilateral surgery. Six of the 210 operated ears had obliterative otosclerosis. The average preoperative and postoperative air-bone gap was 32.06 and 4.39 dB, respectively. The mean preoperative and postoperative bone conduction threshold was 23.17 and 19.82 dB, respectively. A total of 184 (87.6%) ears had a residual air-bone gap <10 dB, and 196 (93.3%) had a residual air-bone gap ±15 dB. Two patients (0.95%) had severe sensorineural hearing loss. Conclusion Stapes surgery showed excellent functional hearing outcomes in this study. This surgerymay be performed in educational institutions with the supervision of experienced surgeons.
bookPart Paralisia Facial Periféria(2016) BENTO, Ricardo Ferreira; FONSECA, Anna Carolina de Oliveira; BRITO NETO, Rubens Vuono de- Cochlear Implantation and Single-sided Deafness: A Systematic Review of the Literature(2016) CABRAL JUNIOR, Francisco; PINNA, Mariana Hausen; ALVES, Ricardo Dourado; MALERBI, Andrea Felice dos Santos; BENTO, Ricardo FerreiraIntroduction Current data show that binaural hearing is superior to unilateral hearing, specifically in the understanding of speech in noisy environments. Furthermore, unilateral hearing reduce oné s ability to localize sound. Objectives This study provides a systematic review of recent studies to evaluate the outcomes of cochlear implantation in patients with single-sided deafness (SSD) with regards to speech discrimination, sound localization and tinnitus suppression. Data Synthesis We performed a search in the PubMed, Cochrane Library and Lilacs databases to assess studies related to cochlear implantation in patients with unilateral deafness. After critical appraisal, eleven studies were selected for data extraction and analysis of demographic, study design and outcome data. Conclusion Although some studies have shown encouraging results on cochlear implantation and SSD, all fail to provide a high level of evidence. Larger studies are necessary to define the tangible benefits of cochlear implantation in patients with SSD.
bookPart Doenças da Orelha(2016) BENTO, Ricardo Ferreira; FONSECA, Anna Carolina de Oliveira; PEREIRA, Larissa Vilela- Decompression of the tympanic and labyrinthine segments of the facial nerve by middle cranial fossa approach: an anatomic study(2016) PEREIRA, Marcos Alexandre da Franca; BITTENCOURT, Aline Gomes; ANDRADE, Emerson Magno de; BENTO, Ricardo Ferreira; BRITO, Rubens dePeripheral facial palsy is characterized by the permanent or temporary interruption of facial muscle function. The middle cranial fossa (MCF) approach has been used to decompress the facial nerve (FN) when hearing needs to be preserved. In this work, we describe a technique for decompressing the FN through the MCF approach, which allows the direct exposure of the labyrinthine and entire tympanic segment of the FN, with preservation of inner ear function. Twenty cadavers heads were used in this study. The reference landmarks used were the middle meningeal artery, greater superficial petrosal nerve, arcuate eminence, inferior petrosal sinus and meatal plane following the petrous apex from its most anterior and medial portion. The tympanic segment of the FN presented, on average, a total length of 11 +/- 0.67 mm to the right and 11.5 +/- 0.60 mm to the left. The longitudinal lengths of the bone window in the tegmen tympani were 16.8 +/- 1.67 mm to the right and 16.8 +/- 1.20 mm to the left. The cross-sectional lengths of the bone window in the tegmen tympani were 5.5 +/- 1.20 mm and 5.0 +/- 1.75 mm to the right and left sides, respectively. The average value of the elliptical area formed by the longitudinal and transversal lengths of the bone window made in the tegmen tympani was 72.5 +/- 22.5 mm(2) to the right and 65.9 +/- 30.3 mm(2) to the left. The proposed technique can be used for the surgical decompression of the tympanic, labyrinthine and meatal segments of the FN through the MCF in addition to reducing the surgical time and the risk to patients.
bookPart Princípios da Semiologia Otorrinolaringológica(2016) BENTO, Ricardo Ferreira- Residual Hearing Preservation with the Evo® Cochlear Implant Electrode Array: Preliminary Results(2016) BENTO, Ricardo Ferreira; DANIELI, Fabiana; MAGALHÃES, Ana Tereza de Matos; GNANSIA, Dan; HOEN, MichelAbstract Introduction The preservation of residual hearing is currently an important challenge for cochlear implant surgeries. Indeed, if patients exhibit functional hearing after cochlear implantation, they can benefit from the combination of acoustical stimulation, usually in the low-frequencies and electrical stimulation in the high-frequencies. This combined mode of stimulation has proven to be beneficial both in terms of speech perception and of sound quality. Finding the right procedures for conducting softsurgeries and designing electrode arrays dedicated to hearing preservation is an open issue. Objective The objective of this study is to evaluate the combination of a soft-surgery procedure implicating round-window insertion and the use of dexamethasone and hyaluronic acid during surgery, with the use of a specifically designed straight soft electrode array, on hearing preservation in patients with functional hearing in the low frequencies. Methods This pre-clinical trial was conducted on seven patients with residual hearing in the low frequencies. The surgical method used employed a round window insertion and the use of topical dexamethasone. Results The soft-surgery protocol could be successfully followed in five patients. In this group, the average hearing threshold shift compared with pre-operative values was of 18.7 þ/ 16.1 dB HL up to 500 Hz and 15.7 þ/ 15.1 up to 1 kHz, demonstrating satisfying levels of hearing preservation. Conclusion We were able to demonstrate the possibility of preserving residual hearing in most of the patients using the EVO electrode. Significant residual hearing preservation levels were was obtained when a soft surgical approach involving round window insertion, dexamethasone and hyaluronic use during the surgery.
- Moving Beyond GDP: Cost Effectiveness of Cochlear Implantation and Deaf Education in Latin America(2016) EMMETT, Susan D.; TUCCI, Debara L.; BENTO, Ricardo F.; GARCIA, Juan M.; JUMAN, Solaiman; CHIOSSONE-KERDEL, Juan A.; LIU, Ta J.; MUNOZ, Patricia Castellanos de; ULLAURI, Alejandra; LETORT, Jose J.; MANSILLA, Teresita; URQUIJO, Diana P.; APARICIO, Maria L.; GONG, Wenfeng; FRANCIS, Howard W.; SAUNDERS, James E.Hypothesis: Cochlear implantation (CI) and deaf education are cost effective management strategies of childhood profound sensorineural hearing loss in Latin America. Background: CI has been widely established as cost effective in North America and Europe and is considered standard of care in those regions, yet cost effectiveness in other economic environments has not been explored. With 80% of the global hearing loss burden existing in low-and middle-income countries, developing cost effective management strategies in these settings is essential. This analysis represents the continuation of a global assessment of CI and deaf education cost effectiveness. Methods: Brazil, Colombia, Ecuador, Guatemala, Paraguay, Trinidad and Tobago, and Venezuela participated in the study. A Disability Adjusted Life Years model was applied with 3% discounting and 10-year length of analysis. Experts from each country supplied cost estimates from known costs and published data. Sensitivity analysis was performed to evaluate the effect of device cost, professional salaries, annual number of implants, and probability of device failure. Cost effectiveness was determined using the World Health Organization standard of cost effectiveness ratio/gross domestic product per capita (CER/GDP)<3. Results: Deaf education was very cost effective in all countries (CER/GDP 0.07-0.93). CI was cost effective in all countries (CER/GDP 0.69-2.96), with borderline cost effectiveness in the Guatemalan sensitivity analysis (Max CER/GDP 3.21). Conclusion: Both cochlear implantation and deaf education are widely cost effective in Latin America. In the lower-middle income economy of Guatemala, implant cost may have a larger impact. GDP is less influential in the middle- and high-income economies included in this study.